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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. GARY J FREDERICKSEN, LICSW

Active Sole Proprietor

MR. GARY J FREDERICKSEN, LICSW is a Clinical Social Worker healthcare provider located in LACEY, Washington. NPI 1700950557 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · LACEY, WA

Registration Details

NPI Number
1700950557
Provider Type
Individual
Gender
Male
NPI Issued
Nov 20, 2006 (19.690106568566 yrs)
Last Updated
Jul 20, 2007
Licenses
LW00004165 (WA)
LW00004165 (WA)
Sole Proprietor
Yes

Practice Information

Address
4422 6TH AVE SE
LACEY, WA, 985031020
Browse WA providers · Browse ZIP 98503
Phone
3607047170
Fax
3604124982
Primary Specialty
Clinical Social Worker
1041C0700X
Additional Specialty
Clinical Social Worker

Other Clinical Social Worker Providers in LACEY, WA

Name Credential NPI
MRS. BRENDA L KITTRELL LMSW, ACSW, MAC 1033187521
LYNN GROTSKY LICSW 1518076504
DR. LORI A SIRS LICSW 1811062243
MRS. MICHELLE MARIE CROWELL LICSW 1376669671
CARY C REID 1245424100
MR. JASON O'RYAN ARNOLD LICSW 1174758700
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.